Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 13590 | Date 10/10/2025 |
| Token No | SM/25-26/2241 10/10/2025 | Serial | 009 |
| Patient Name | Mrs. BAISHAKI BUCHCHA | Contact No | 6289356517 |
| Address | 55D THAKURBATI STREET | Age | 25 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||